Neuropsychologist Warns Against Pathologizing Normal Childhood Struggles
A clinical neuropsychologist argues that parents and schools are too quick to label ordinary developmental challenges as disorders, and that this trend is harming children's mental health.
A clinical neuropsychologist is warning that American children are being harmed by an increasingly common habit: treating every ordinary struggle as a diagnosable disorder. In an opinion piece, the specialist argues that parents, schools, and clinicians are too quick to reach for labels, accommodations, and services when children face normal developmental challenges, and that this medicalization often backfires.
The argument is illustrated by a patient identified as Zach, a high-achieving tenth grader who was earning top grades in accelerated classes, starting on the varsity basketball team, competing in Math Olympiad, and playing French horn in the school band. He began preparing for the ACT in April of his sophomore year with a tutor who charged $800 an hour for two-hour sessions twice a week. Within weeks, Zach was in the psychologist's office insisting he could not do well, even though he was consistently scoring 34 on practice tests — a near-perfect result that places him in the top percentile nationally. He wanted a perfect 36 to improve his chances at the University of Pennsylvania, and he asked the psychologist to write a letter recommending testing accommodations so he could get extra time.
The psychologist, who provides psychotherapy and cognitive remediation to children with learning and related developmental disorders, says the case reflects a broader cultural problem. From the first pediatric checkup, parents are socialized to track height, weight, and head circumference percentiles, and that obsession with numbers can carry over into an fixation on teenage test scores. Parents often worry about a score in the 37th percentile, the psychologist notes, even though that is solidly average. The average range is wide, and in most domains the healthy middle is optimal. Attention and anxiety work the same way: too little of either causes problems, but so does too much.
The piece also challenges the assumption that more measurement and more intervention are always better. Scores are snapshots in time, subject to measurement error, and they are imperfect predictors of future performance. Perseverance, creativity, and people skills — traits that often matter most for success — usually cannot be measured at all. Yet parents feel squeezed from both ends: if a child struggles, they look for a diagnosis; if a child excels, they worry about perfectionism or anxiety. The messy middle, where most healthy development happens, seems to have disappeared.
Interventions carry opportunity costs, the psychologist argues. Every minute and dollar spent on therapy is a minute and dollar not spent on soccer practice, day camp, playdates, or ordinary homework. The choice is not between an intervention and doing nothing, but between an intervention and something else that might bring a child joy and enrichment — and might even build the perseverance, creativity, and people skills that matter later. The psychologist also warns that diagnostic labels can work against mental health by locating problems in the brain and outside a child's control, reinforcing helplessness and an external locus of control, which are features of depression. The conclusion is not that real disorders should be ignored, but that normal struggles should not be treated as disorders.
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